Nutrition Education Using Emo-Demo in New
tation in their community. In East Java, most of ciyies or disctrics use this method as part of promoting nutritional behavior in the community.
The implementation of the Emo-Demo involves the community around 5-20 people from posyandu and trainee. The New Normal era is an uncertain- ty for social, economic and health conditions [5]. The COVID-19 outbreak encourages us to comply some health protocols by wearing masks, avoiding crowded, social distancing and always washing hands with soap as new behav- iors. This policy changes all programs or activities by using digital technology to provide nutrition education especially through the Emo-Demo method, so that it can run properly. The digital technology is one of the solutions for this outbreak problem [2].
The use of digital technology is actually not new nowadyas, especially in the 4.0 industrial where there is a blend technology forming physical, bio- logical and digital dimensions with a complicated combination [4]. Digitaliz- ing information and massive use of artificial intelligence in various sectors of human life, including the world of education is as a sign of the 4.0 era [4].
Although the digital era 4.0 is identified in industry, empowerment of the community and field activities is still limited. The covid-19 outbreak condi- tion forces all aspects to accelerate the use of digital technology to prevent the transmission of the virus. Although condition is changing, it develops new symbolic interactions as part of communication in order to achieve the goals.
Larossa and Donald C. Reitzes quoted by Richard and Lynn in their book Introduction to Theory of Analysis and Application translated by Maria said that symbolic interaction is:
“In essence..., understanding a frame of reference for understanding how humans, getting along with others, create the symbolic world and how this world, in turn, shapes human behavior”. (2009:96)
By using a literature review, author's experience, interviews and GAIN data, this paper will discuss: the ways GAIN provides Emo-Demo training for nutrition education in community especially in New Normal era, the chal- lenges faced in strengthening the capacity through technology, and the use of technology by participants as part of an understandable symbolic interaction [5].
Discussion
GAIN's role in accelerating stunting prevention is to provide suggestions to Indonesian Government, Health Ministry, nutrition stakeholders, academ- ics, business actors, and development partners who develop and mobilize food and nutrition plans to maximize the nutritional impact of all people (Utama, n.d.). Through a Memorandum Saling Pengertian (MSP) with Health Min-
istry of Indonesia in 2017-2020 with a nutrition improvement program for 1000 HPK facilitated by the East Java Health Service through Baduta 2.0 program in Trenggalek, Probolinggo, Bondowoso, Jember and Surabaya City.
The Baduta 2.0 program includes; 1) Technical and funding support for the adoption of Emo-Demo for Infant and Child Feeding (Pemberian Makan Bayi and Anak or PMBA) at posyandu; 2) advocacy and technical support for the implementation of the 10 Steps to Successful Breastfeeding (Langkah Menuju Keberhasilan Menyusui or LMKM) in health facilities; 3) Collection, selection and dissemination of Most Significant Change (MSC); and 4) social marketing test of nutritional powder (Burvita). From those 4 programs, a support for the adoption of Emo-Demo session attracted a lot of interest from stakeholders, especially the Health Office and academics [6].
Emo-Demo is a guide activity to convey a simple message in a fun or emotional way, thus making it memorable and impactful rather than other conventional behavioral changing strategies. The educational sessions were claimed more innovative and participative which have an important message by using interesting game media adapted to posyandu’s trainee or those with- out a health sector background. The contents of the message are about giving iron-rich foods to pregnant women, exclusive breastfeeding, complementary feeding, healthy snacks for children and washing hands with soap. This educa- tional session with Emo-Demo was meant to ask pregnant women, mothers, and caregivers for toddlers so that children 0-24 months can be fulfilled their nutririon needs [8].
As a new method which is done in groups of 6-20 people in 1 session, Emo-Demo used interactive games. Facilitator’s task is to facilitate the learn- ing process by giving instruction in daily and simple language. During the communication process, participants will be able to raise awareness and be reflective. George Herbert Mead saw that humans are the most rational beings who have self-awareness, and their biological aspects, which have social nature as well, influence a motivation to do or act. Mead stated that communica- tion is an expression of feelings and movement is an act that is carried out by someone in its relation to others. In addition, humans have an ability to respond themselves consciously, and this ability requires reflective thinking ability. Thus, the method using free local language can be a media for nutri- tion education [9].
Evryone can bean Emo-Demo facilitator as long as they have been trained based on the developed module. Nowadays, the training is carried out offline by the Health Office, academics, other sectors by submitting a request for a facilitator to GAIN. The training is carried out for a minimum 3 days for 12 Emo-Demo game guides with a maximum of 20 participants for large
classes and 10 for micro teaching or practical classes. This training must be carried out in groups, especially in demonstrating and practicing using media.
There are 36 cities/ regencies in East Java and 7 other provinces that used this method and 15 universities have included it in their learning. Challenges arise during a pandemic which makes all activities have to be more flexible without compromising the quality of training. Several ways and challenges of GAIN in providing nutritional information by strengthening capacity through the Emo-Demo method in new normal era and supporting government policies include [10]:
a. Training via online (zoom)
Because of the restriction from Health Ministry about Covid-19, Zoom has been used since March 2020 by GAIN to give an access for other cities or regencies. Zoom is very applicable and simple to use because it is able to accommodate 100 participants for pro accounts. For the participants, they just need to download it and it will be able directly to access either via laptop or mobilephone.
By collaboration with Andalas University, GAIN used Zoom for 50 cities in West Sumatra. Some areas trained by GAIN using Zoom are:
No.ProvinceRegionAgencyYearMonthDateTrainingParticipant Data TypeMethodPartcipantModuleJob 1West Sumatera 50 Regencies/ cities
Universitas Andalas2020August5,6
Training of T
rainerOnline145Health Workers 2West Sumatera
50 Regencies/ cities
Universitas Andalas2020August11,12TrainingOnline604Trainee 3East JavaNgawi Regency
Health Office2020September8,9,10TrainingOnline2412Health Workers 4East JavaMalang CityHealth Office2020October
7,8,9 and 12-14
TrainingOnline1683Trainee 5East JavaBojonegoroHealth Office2020October20,21TrainingOnline728Trainee 6Mojo kertoHealth OfficeHealth Office2020November10,11,12TrainingOnline12Health Workers 7East JavaNgawi Regency
Health Office2020November
Last of NTrainingOnline3012Health ovemberWorkers 8
DKI Jakar
taJakartaUniversitas A-Azhar2020November
and December
28 and 5TrainingOnline76Nutrition’s lecturer
Some issues found in using zoom for Emo-Demo training were:
1. host had less ability to master the technology;
2. internet and signal were not good;
3. it needed 2 laptops as a backup if 1 laptop had problem;
4. the camera on the participant's laptop must be able to reach all participants so that the facilitator can see it and be interactive;
5. before training process, briefing needed a process for the committee be- cause they will replace the facilitator accompanying the participants;
6. before training, the committee must master game’s tool and module, so media can be used as much as possible;
7. online training was hold for a maximum of 8 hours regarding to partici- pants level of fatigue;
8. an interactive module still required a minimum of 2 people in one zoom room; and
9. some modules were implementated based on social distancing.
Although facing several problems during the process, the participants were able to enjoy the training and could be implemented at posyandu by the trinees [6].
b. Making a short video for Emo-Demo guide
GAIN was able to make a short video to support Emo-Demo method.
There were 24 short videos about Emo-Demo game guide with theme of ATIKA (chicken heart, egg, and fish), exclusive breastfeeding, complemen- tary foods for breastfeeding, healthy snacks and hand washing with soap.
c. Developing new guide/module with soft-file
At the beginning, there were only 12 modules game guide were printed.
Having support from Health Office and other training doers, there were 24 more modules which had been developed and distributed via soft-files.
So, the participants can download the video through Google Drive link, website, and youtube.
d. Creating a website about Emo-Demo
The website had been made to support education via Emo-Demo. The awebsite is emodemo.org. This website contains a complete information about Emo-Demo from its definition, process and game guide.
e. Utilizing youtube about how to do Emo-Demo
The video was uploaded to youtube in order to expand the networking and to follow today’s technology. Youtube is a media that is often accessed by people.
1) Emo-Demo Imagining the Future:
http://bit.ly/GAINModulEmoDemo4MEMBAYANGKANMASADE- PAN
2) Ready-to-Go Emo-Demo: http://bit.ly/GAINModulEmoDemo- 7SIAPBEPERGIAN
f. Creating a KIMO application for android based on the information in Emo-demo
For android holders, there is a KIMO application which provides some key messages for pregnant women to change their behaviour in Emo-Demo program. This application is collaborated with Sailent and Agate, it can be downloaded at https://play.google.com/store/apps/details?id=com.agate.
kimo
g. Making a video about the Most Meaningful Changing Stories from participants for the evaluation
To support the implementation of Emo-Demo, a video about the stories from participants was made in order to provide information and motivation for other participants. This video shown the changes of feeling and benefits from participants. In addition, it also can motivate nutrition care groups to use this method in educating the community. This video had been upload- ed on Youtube with link: http://bit.ly/MSC_BerjuangDemiASIuntukBay- iPrematur .
GAIN has implemented nutrition education with Emo-Demo method, especially to support community such as health workers, trainees, Non- Government Organizations (NGO) and academics by using digital technology with zoom, youtube, websites, KIMO applications and videos. The flexibility of a program is a condition to support a bureaucy or policy in new normal, where technology becomes an instrument. GAIN as Non-Government Organizations (NGOs) have to be able to implement new alternative methods to support the Ministry of Health in bureaucratic reform 4.0. It includes three aspects: collaboration, innovation, and the use of information and communication technology [1]. The New Normal era makes all NGOs have to change their management tools and policies, such as a trainer coordinator who avoids activities outside the city as much as possible.
Educational interaction between the GAIN team and the participants has become a new communication space from direct interaction to online intercation. This interaction shows that nutrition education process can be carried out in new ways and be done well. As a result, the participants showed
that they were able to understand and implement it well. The indicators of the successful implementation through online and other digital technologies are; (a) at post-training, Ngawi Health Office conducted an Emo-Demo at the posyandu facilitated by the trainee, (b) there were a request of online training from Mojokerto, Universitas Al Azhar and Bojonegoro, and (c) soft- files about game guide had been requested frequently as educational materials from Health Office or other nutrition cares [3].
Conclusion
Providing nutrition education for 1000 HPK to accelerate stunting pre- vention requires the involvement of social organizations such as GAIN which using Emo-Demo method. The implementation in groups must begin with strengthening the capacity of its facilitator. The adoption of Emo-Demo by the East Java Provincial Office and the Ministry of Health encouraged GAIN to increase the capacity and academics for all regions in Indonesia. Regard- ing to government policy and resctriction about Covid-19, GAIN uses the strategy considered from bureaucratic reform 4.0 and digital technology such as zoom, website, youtube, the KIMO android application, and short video about game guides and MSC.
Challenges such as signals, cooperative training teams, internet data, and supporting infrastructure and tools such as laptops were faced by GAIN in implementation of Emo-Demo method. Behind these challenges, it turns out that communication using existing technology such as interaction by using videos and soft-file material were successful to understand by the participants and it is hopefully useful for Emo-Demo participants and academics.
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